Measuring the effectiveness of hysteroscopic resection of symptomatic cesarean scar defects and its effect on quality of life

Authors

1 Assistant Professor of Obstetrics and Gynecology, Department of Obstetrics and Gynecology, Faculty of Medicine, Suez Canal University. Ismailia, Egypt.

2 obstetrics and gynecology, faculty of medicine, suez canal university, ismailia, Egypt

3 Professor of Obstetrics and Gynecology, Department of Obstetrics and Gynecology, Faculty of Medicine, Suez Canal University

4 Lecturer of Obstetrics and Gynecology, Department of Obstetrics and Gynecology, Faculty of Medicine, Suez Canal University.

Abstract

Background: Cesarean section (CS) delivery increased to represent more than one third of all deliveries. CS related complications include CS scar defects that result in abnormal uterine bleeding which affect female sexual function and women’s quality of life.
Aim: To evaluate the effectiveness of hysteroscopic resection of cesarean scar defects in symptomatic women.
Materials and methods: A randomized clinical trial conducted in the obstetrics and gynecology department of a tertiary hospital. Patients were recruited according to inclusion and exclusion criteria. 70 Patients were allocated into two groups: a study group who had hysteroscopic resection of the scar defect and a control group who were managed ex- pectantly. Patients were assessed for postmenstrual spotting amount and duration. Evaluation of spotting related discom- fort and dysmenorrhea was done using a visual analogue scale. Quality of life was evaluated using the Arabic vali- dated SF 36 quality of life questionnaire. Patient satisfaction was measured using a five- point Likert scale.
Results: There was a statistically significant difference between both groups regarding the total number of spotting days post-procedure. The visual analogue scale decreased from 8.37 ± 1.57 and 2.69 ± 1.57 to 3.31 ± 1.76 and 1.43 ± 1.01 for discomfort and dysmenorrhea respectively in the study group. The study group showed significantly increased scores of each component of the quality-of-life questionnaire. Patients’ satisfaction was significantly increased in the study group than the control one. The overall satisfaction rate was 74.28%.
Conclusion: Hysteroscopic niche resection resulted in improved patients’ symptoms and quality of life.

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